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下一代移动心脏遥测技术:心电图与生理参数相结合的临床价值

Next-generation Mobile Cardiac Telemetry: Clinical Value of Combining Electrocardiographic and Physiologic Parameters.

作者信息

Yoo Dale, Bhalla Karan, Manyam Harish, Pubbi Dinesh, Lieber Ira H

机构信息

Heart Rhythm Specialists, PLLC, Dallas, TX, USA.

ORION MEDICAL, Comprehensive Cardiovascular, Sleep Medicine and IAC Accredited Vein Center, Pasadena, TX, USA.

出版信息

J Innov Card Rhythm Manag. 2022 Aug 15;13(8):5135-5146. doi: 10.19102/icrm.2022.130807. eCollection 2022 Aug.

DOI:10.19102/icrm.2022.130807
PMID:36072445
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9436405/
Abstract

The ZOLL Arrhythmia Monitoring System, a mobile cardiac telemetry (MCT) device from ZOLL Corporation (Chelmsford, MA, USA), records single-channel electrocardiogram (ECG) signals, heart rate, activity, respiratory rate, and posture. Comprehensive reporting from these multiple biometrics may provide a global evaluation of arrhythmic or other cardiovascular risks in individual patients and insights into the patient's overall wellness and health status. The objective of the study was to evaluate the physician-perceived utility of adding biometric data to the traditional ECG-only-based assessment and subject-reported symptoms. This prospective study recruited candidates for MCT. Independent event and end-of-use (EOU) reports based on ECG and biometrics data were provided to physicians. To document whether the biometric data affected treatment plan decisions or added value over the ECG-alone data, physicians completed a questionnaire for each report. Additionally, they completed the questionnaire to understand the utility of the subject wellness information provided in the EOU report. From December 2020 to July 2021, 583 patients were enrolled by 27 physicians from 18 cardiology practices in the United States. When using biometrics data compared to the ECG alone, this study found that 96% of the physicians made changes to the treatment plan that initially was based on the ECG alone. The biometrics-based changes involved 64% of all patients (n = 535), and included modifications to medications, follow-up, and lifestyle in 18%, 19%, and 63% of the subjects, respectively. In this largest MCT study conducted to date, next-generation MCT, by providing multiple biometric parameters along with ECG data, improves physicians' ability to make patient management decisions. This added functionality and clarity may replace traditional "ECG with diary"-based monitoring.

摘要

ZOLL心律失常监测系统是美国ZOLL公司(位于马萨诸塞州切尔姆斯福德)生产的一种移动心脏遥测(MCT)设备,可记录单通道心电图(ECG)信号、心率、活动、呼吸频率和姿势。这些多种生物特征的综合报告可以对个体患者的心律失常或其他心血管风险进行全面评估,并深入了解患者的整体健康状况。本研究的目的是评估医生认为将生物特征数据添加到传统的仅基于心电图的评估和患者报告的症状中的效用。这项前瞻性研究招募了MCT的候选人。基于心电图和生物特征数据的独立事件和使用结束(EOU)报告被提供给医生。为了记录生物特征数据是否影响治疗计划决策或比仅心电图数据增加了价值,医生为每份报告填写了一份问卷。此外,他们还填写了问卷以了解EOU报告中提供的患者健康信息的效用。2020年12月至2021年7月,美国18家心脏病学诊所的27名医生招募了583名患者。与仅使用心电图相比,使用生物特征数据时,本研究发现96%的医生对最初仅基于心电图的治疗计划进行了更改。基于生物特征的更改涉及所有患者的64%(n = 535),分别包括18%、19%和63%的受试者的药物调整、随访和生活方式改变。在迄今为止进行的这项最大规模的MCT研究中,下一代MCT通过提供多个生物特征参数以及心电图数据,提高了医生做出患者管理决策的能力。这种增加的功能和清晰度可能会取代传统的基于“带日记的心电图”的监测。

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